BEUDAMED
    FDA Adverse Event Injury Summary report: N

    WILSON - COOK MEDICAL INC

    MDR report key: 217867 · Received April 6, 1999

    Report

    Report Number
    217867
    Event Type
    Injury
    Date Received
    April 6, 1999
    Date of Event
    April 5, 1999
    Report Date
    April 5, 1999
    Manufacturer
    WILSON - COOK MEDICAL INC
    Product Code
    KNQ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    RADIOLOGICALLY ASSISTED PLACEMENT OF GUIDEWIRE TO STOMACH; DILATOR PASSED OUR GUIDEWIRE EASILY; UNABLE TO PULL GUIDEWIRE OUT WITH 2 ATTEMPTS; WHEN BOTH DILATOR & GUIDEWIRE PULLED OUT; GUIDEWIRE BENT NEAR END (2 1/2" FROM END).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 WILSON - COOK MEDICAL INC STANDARD WIRE GUIDE KNQ WILSON - COOK MEDICAL INC * 102875308

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Required Intervention